Mainstream in 2012

The future of the mainstream approach in mental health recovery is bleak.  Once pioneered as the most radical yet realistic approach to the care pathway, mainstream has now been side-lined and pushed into a corner.

The thinking behind mainstream in mental health is simple.  Linking up individuals with mainstream areas of their own choice as part of recovery.  These areas or 'social domains' cover a wide spectrum: the arts, employment, volunteering, sport and healthy living, faith, worship or spirituality, employment, self-employment, education and business.

In 2012, the cuts in mental health provision are deep and across the board.  Employment is touted as a be-all and end-all yet employment often only happens through a gradual re-introduction to mainstream living .  This is especially true for people who are in secondary mental health care with a diagnosis of 'severe and enduring' conditions.

The outcomes that have been attained by individuals who have been referred or self-referred to a mainstream service are often formidable.  Access to mainstream arts providers such as music recording studios, visual arts courses or creative writing workshops have led to individuals succeeding in employment, self-employment, higher education and collaborative enterprises with their peers.

The mainstream approach goes far beyond therapies and this blog contains many examples of its success.

Mainstream is based on recovery as opposed a 'cure'.  It is also based on the individual claiming his or her right to mainstream living along with everyone else.

The opportunity to access mainstream on his or her own terms is not denied to an individual with a 'severe and enduring' mental health diagnosis. Mainstream can be highly supportive of clients' individual aspirations and self-development. Sometimes this encouragement comes directly from the mainstream outlet itself rather than being dictated by carers, statutory services or voluntary agencies. What can be denied and often is, is the opportunity to access the opportunities in the first place.

In many cases, an individual with a 'severe and enduring' mental health diagnosis will only have the chance to access a mainstream activity if it is built in to his or her care pathway and recovery plan.  The professionals who can help signpost people to such activities will be skilled in allowing individuals to identify personal goals and aspirations.  They will also need skills in knowing exactly where the mainstream sites are where an individual can develop and pursue his or her aspirations.   Linking someone up with a mainstream activity of his or her own choice allows that mainstream venue to provide exactly what it is already providing for its clients, users and consumers. 

The client with a mental health diagnosis will be treated no differently from anyone else, unless he or she has specificied particular adjustments.  That too is part of person-centred planning, with individuals free to disclose or not as they deem fit.

There are sound reasons for mainstream being a lot less discriminatory and stigmatizing than it can be portrayed. Mainstream allows individuals to access services as consumers with consumer rights. If someone with a mental health diagnosis freely chooses to develop his or her aspirations in a mainstream environment, there is no good reason why that person should be denied any of the services that particular venue may provide. The client is accessing mainstream as a consumer of that service, not as a 'diagnosis'.

Once a firm relationship with mainstream has been established, there are multiple ways that mainstream finds to continue to develop individual hopes, dreams and aspirations. I have clients who have found employment through accessing music by rehearsing regularly in a mainstream recording studio. Others have opted to join higher and further education outlets to progress with their dream. Yet others have become volunteers in an environment they enjoy. This has not happened because I have requested the venue to provide employment for my clients Far from it - the venue itself often instigates the process or helps provide the signposting. In many cases this can lead an individual towards a working role in the environment where he or she happens to feel most fulfilled.

This is the viral effect of mainstream

MHFA - crisis intervention

In addition to the umbrella intervention provided by ALGEE (Assess Risk, Listen non-judgementally, Give reassurance, Encourage referral to other agencies, Encourage self-help strategies), MHFA has strong and clear guidelines for crisis intervention. From MHFA:
Crisis First Aid for someone experiencing an acute psychotic episode

• Do not get involved physically
• Call the police and explain what is happening, unless the person has a mental health crisis card with clear steps describing how you can help.
• Try to create a calm, non-threatening atmosphere.
• Be reassuring, calm and concerned.
• Do not try to reason with someone who is experiencing acute psychosis.
• Express empathy for the person’s emotional distress.
• Comply with reasonable requests

MHFA Testimonials & Feedback

MHFA Training delivered by Middlesbrough and Stockton Mind on behalf of the NE Mind Partnership have trained over 1800 individuals with outstanding feedback and results.

Mental Health First Aiders were asked for there stories on how MHFA has helped them. These are just a small selection;

I use MHFA daily, for example I had a tenant suffering a psychotic episode which I felt confident to deal with

I have used MHFA when a young Mum came into the centre and told me she felt like ending it all

I use it on a daily basis with clients and colleagues and feel I have made a real difference

I have a work colleague who suffers from epilepsy and associated depression and anxiety. I used ALGEE and offered advice and guidance over the phone.

Who should take an MHFA England course?

Who should take an MHFA England course?

Anyone can benefit from Mental Health First Aid (MHFA). It is open to members of the general public. Families affected by mental health problems, teachers, health service providers, emergency workers, frontline workers who deal with the public, volunteers, human resources professionals, employers and community groups are just a few of the groups who have benefited from MHFA.

Mental Health First Aid covers a comprehensive range of common mental health conditions and their appropriate first aid interventions.  The conditions covered range from psychosis to phobia, from bi-polar to anxiety, from schizophrenia to stress at work.  From this point-of-view MHFA is highly intensive, detailed and excellently put together.

It is important to bear in mind that MHFA is more than mental health awareness.  A good mental health awareness course may well be a good 'Level I' for those who wish to find out more about general  mental health before deciding to go on to MHFA at 'Level II'.